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Abstract

Background

Patients with thalassemia major (TM) require repeated blood transfusions, which leads to accumulation of iron in a wide variety of tissues. Accumulation of iron in the pituitary gland can lead to irreversible hypogonadotropic hypogonadism (HH) in this group of patients.

Purpose

To investigate the reliability of pituitary-R2 as a marker to estimate the extent of pituitary iron load by comparing the pituitary magnetic resonance imaging (MRI) findings with hepatic iron load and serum ferritin levels.

Material and Methods

A total of 38 β-TM patients were classified into HH (group A, n = 18) and non-HH (group B, n = 17) groups. A third group, group C, consisted of 17 healthy participants. Each participant underwent 1.5-T MRI examinations. Pituitary gland heights (PGH), pituitary-R2 values, and liver-R2 values were measured by using multi-echo spin-echo sequences.

Results

Pituitary-R2 values were significantly higher in group A compared with group B (P < 0.05). A positive correlation was detected between the pituitary-R2 values and serum ferritin levels in TM patients (P < 0.01). A threshold value of 14.1 Hz for pituitary-R2 was found to give a high specificity and sensitivity in distinguishing the TM patients with HH from those with normal pituitary functions. PGH measurements were significantly lower in group A compared with group B (P < 0.05).

Conclusion

MRI-assessed pituitary-R2 seems to be a reliable marker for differentiating the TM patients with normal pituitary function from those with secondary hypogonadism due to iron toxicity.

Keywords

β-thalassemia hypogonadotropic hypogonadism iron load magnetic resonance imaging (MRI)pituitary gland

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MRI assessment of pituitary iron accumulation by using pituitary-R2 in β-thalassemia patients

Abstract

Background

Purpose

Material and Methods

Results

Conclusion

Keywords

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References